HomeMy WebLinkAboutBALFOUR ST 2Name Service No.
I Address #i 2 Ba IFouR 5+.I •
Location
Kind of Pipe Sin Sin of Main
Repair-Renewal-New Service Location
Date [Material Amount Total Date Amount
~-3-671 I I
4>0 1 a;f'IV"a NSi1e I
I ~/"ElboYl ,
I
i
Labor
HP-6411 ,-
TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
DATE .............•.•.•••••••NO .
The undersigned applies for the construction of a particular sewer connecting No........................•.
Street and hereby agrees to comply with the Rules and Regulations governing the construction and use of Particular
Sewers,as now or at any future time established by the Board of Selectmen.
Am't of estimate $ .
Am't Paid $...............•
.Ov.tner
Sketch of Service Here
Connection made in Street.
Remarks:
Work completed 19..